Tuesday, November 1, 2011

Antidote for the Alzheimer's Epidemic

Contributed by: Dennis Fortier, President, Medical Care Corporation

Surely, you’ve all read the grim reports about Alzheimer’s disease.  The advancing age of the US population will usher forth an Alzheimer’s epidemic in the coming decade. The emotional toll of this epidemic will be immeasurable, and the financial impact could bankrupt the Medicare system.

That dire version of the story might sell newspapers, but it doesn’t really reflect the available options to a nation with a will to fight back.  The good news is: we can manage this problem.  And no elusive scientific discoveries are required to do so.  We merely need to implement the medical knowledge that is already in hand. 

To be clear, scientific advances yielding better treatments and more accurate diagnostic approaches will greatly improve our prospects in this battle.  We need to aggressively fund research and push forward on that front.  However, it is important to recognize the sizeable gap between the high standard of care that is achievable based on the current state of medical knowledge, and the lagging standard of care that is routinely implemented in a primary care clinic.

Pragmatism: Closing the Gap
Closing the gap in the Alzheimer’s field could yield tremendous benefits.  It will take some effort, but we can achieve such a goal through pure effort and public will.  Compared to solutions based on the hope of new scientific discoveries, this has the appeal of greater certainty. 

To close the clinical gap, we must address three key areas where “common practices” are significantly lagging behind “best practices”. 

1)    Education: We need to promote public education and awareness about the many, common medical conditions that impair memory (depression, anxiety, sleep disorders, thyroid malfunction, vitamin deficiency, medications, etc).  This will reduce stigma associated with memory loss and encourage patients to be more proactive in expressing early concerns to their physicians.
2)    Proven Clinical Standards: We need to help primary care physicians adopt proven standards for differentiating between signs of normal aging and subtle symptoms caused by medical conditions that impair memory. Out-dated assessments for identifying dementia are aiming too late in the process; we need to facilitate effective intervention at an earlier, subtler stage of impairment.  Newer clinical assessment tools can ensure that emerging problems are addressed in a timely manner, prior to unnecessary disease progression and declining health.
3)    Effective Treatment: We need to ensure that patients, physicians, and caregivers can recognize what effective treatment looks like; doing so will aid ongoing compliance with a prescribed regimen of care. Compared to treatments for other causes of memory loss, expectations for treating Alzheimer’s disease are often unrealistic.  For AD, effective treatment is not a complete reversal of symptoms, but rather, a slowing of functional decline.  Importantly, everyone must appreciate that proper treatment for AD involves more than just drugs; it also encompasses proper diet, regular physical exercise, and tight control of other chronic conditions. 

Concrete steps in these three areas will narrow the gap between “current practices” and “best practices”.  Doing so will mitigate the impact from two of the most destructive components of the Alzheimer’s disease problem: under-diagnosis and under-treatment.

Under-Diagnosis
According to the World Alzheimer’s Report 2011, published by Alzheimer’s Disease International, there may be 36 million demented people in the world and 28 million of them are undiagnosed.  That is, no doctor has diagnosed the underlying cause of the dementia and prescribed treatment to resolve the problem.  According to well-accepted prevalence data, a large percentage of these people are demented due to Alzheimer’s disease (AD).  For all of those people, their disease is progressing unabated, their symptoms are progressing, and the ongoing costs of their care are moving irreversibly upward.

Under-Treatment
As of today, AD cannot be cured, but a timely intervention including careful management of diabetes and hypertension, a proper diet, physical activity, and poly-therapy with approved Alzheimer’s drugs, can significantly slow progression for a meaningful percentage of those 28 million people who have been neither diagnosed nor treated.  Additionally, many other conditions that cause memory loss are both common and completely treatable.  If no diagnostic work-up is performed, these conditions go untreated at the ongoing peril of the patient’s health, which ultimately drives the cost of care higher.

Certainly, a better-educated public, timelier diagnosis of medical conditions that impair memory, and robust treatment are all central facets of a solution to the Alzheimer’s epidemic.  Each has deep economic implications underscoring the importance of addressing them. As shown by examples like the Orange County Vital Aging Program*, all of these can be achieved through pragmatic, community-based efforts to improve knowledge and raise standards of care among primary care physicians. 

Overall, the looming threat of an Alzheimer’s epidemic is a real problem that may well have painful consequences. We would all like more certainty that scientific efforts will soon thwart the disease, but we cannot yet count on that with high confidence.  In the meantime, a concerted effort to pragmatically implement the scientific advances from the past decade of research will significantly reduce its likely impact.

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*For more information about the Orange County Vital Aging Program, please visit the OCVA site or download this summary of Year-1 results.

29 comments:

  1. Couldn't agree more. This is perhaps the group that suffers the greatest from the lack of the layman engaging and becoming both educated and pro-active.

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  2. With so many people already having it & the future looks worse what is the anwer to get more studies done? I lost my Mother this year to it & no one should have to endure such a painful diease including the family who suffers along with the patient.

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  3. One can defeat or suppress the onslaught of
    alzheimers by boosting metabolism. It worked for me. My memory and clarity of thinking with ability to multi-task increased hugely. Thoughout our digestive intestines are villi that absorb matter into our blood stream. As we get older the passage of particulates slow way down. As a result we get degraded substances entering our blood stream. This brings on disease, deterioration of our organ functions, and weight gain from the same level of eating. Boosting metabolism worked for me. My type 2 diabetes disappeared; my arthritis pains left; my memory improved as did my clarity of thinking and ability to multi-task; my weigt went down and stayed down; my cholesterol went way down; my skin tightened with better elasticity; and my energy went through the roof. My need for medication went from $4500 per year to $193 through October 2011. My doctor/surgeon loves my solution. I am seeking double blind testing, and I filed for a patent. franklinlacy.com

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  4. Frank Lacy----I am so happy for you and that you were able to accomplish this for yourself.
    But----I might not be the only person reading this who wonders, "but how does one boost one's metabolism? I'd really like to know. Thank's for your valuable input. Marilyn Wood

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  5. Be careful of scam 'treatments' for A.D.

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  6. What about curcumin with vitamin D-3 (otc supplements)taken daily - anyone have an update or new info? Thanks.

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  7. That was so generic. You said the same thing over and over in each paragraph. And what really did you say that was new? Didn't you promise an antidote? Where was it?

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  8. How does one boost their metabolism?

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  9. Why don't you "use your brain" and Google "boost metabolism"? :-)

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  10. Don't believe the claims that the drug manufacturers make about boosting metabolism. The best way to boost metabolism is aerobic exercise. Swimming, cycling, running, power walking, hiking, etc, at least three times per week. I don't know why this article didn't address natural aids such as Tumeric, fish oil, kelp and alfalfa. DO YOUR RESEARCH!!!!!!
    What a useless article.

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  11. I definitely agree with the first paragraph about awareness and acceptance of the general population that the BRAIN is an organ just like the heart, kidneys, lungs etc.. My dad died in 1988 of symptoms of A D although it was little known in 1980 when his problems began. Family members wouldn't visit and the DR that would go to the nursing homes was convicted of Medicare fraud. We have come a long way, but a lot of people look down on those of us who need meds for depression because of chemical imbalances in the organ BRAIN. We are classified as weaklings and that is why it is hidden by many who are treated.

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  12. Yes E must have Regular exercise of all kinds. Diet Fish oil & other supplements But AD will take over if thats in your genetic make up

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  13. My father did everything right. He ate fruits and veggies more than anyone I know. He ate small amounts of healthy protien, exercised, never smoked or drank. Was very healthy and physically fit. Had muscled arms into his sixties. He was diagnosed at 62. He had it before then, but that was his age at official diagnosis. If the doctors don't know, or can't resolve a medical problem they always blame it on the patients lifestyle. Well he had no bad habits and did EVERYTHING right. He still got it. It is a disease. We tried everything that was recommended as far as suppliments, herbs, vitamins, medication. We lost him at age 77. Taking the suppliments and eating the recommeded diet will help your body be healthier, but it will not stop or prevent this disease. Don't waste your money on all the hype and don't let a doctor make you feel like you caused it. What I don't understand is how in the first 50 years or the 1900's they could find cures for diseases, but 60 years later it's only expensive traetments. Hmmm?

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  14. Good luck with the patent office. To subject an already overwhelmed group with something as mundane as a diet will most certainly find it tough going

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  15. The first step in dealing with and treating and preventing dementia is diagnosng it correctly. Unfortunately, we are bombarded with articles such as this that try to suggest that all or nearly all dementias are Alzheimers. Nothing could be further from the truth.

    Many, and probably most dementias are vascualr in nature and caused by many of the same things that cause heart attacks. Namely: hypertension, hypercholesteremia, diabetes, lack of excercise, obesity and so on.

    And, just as we have reduced the number of heart attacks, we can reduce the prevalence of dementia -- using the same medicinces and techniques.

    However, there is no treatment or prevention for Alzheimers disease. Implying otherwise is a scam. True, there are drugs such as Aricept that reportidly delay the progression of the disease. But, frankly, those drugs work better for dememtias such as Lewey Body Dementia than they do for Alsheimers.

    The medical community has to get away from calling all dementias "alzheimers" and start dealing effectively with this very cruel problem. As every physician should know: if you get the diagnosis wrong, you will probably get the treatment wrong too.

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  16. I agree with the person that said how we could find cures for diseases in the first 50 years or the 1900s. Like, for example, polio is the last disease there ever was a cure for! Yet they found a cure for it long time ago. You mean to tell me in this day and age, with all the new technology and information we have, there's never been any cure for any other diseases since polio!! I really think they don't want to find a cure for anymore diseases. They just want to string you along saying they almost have a cure to keep you hoping and donating money for the cause! It's all about money and not really finding a cure, but just treatments and using drugs to keep the Pharmaceutical Companies rich! Nobody has any trouble inventing extrordinary features for a cell phone! It's really sad that everything is just about money and not helping cure a disease for a human being. I really feel that societies for diseases are just into making money and not really wanting to find permanent cures as we did for polio back in the 50s, before everything was all about money only! I'm sorry, but it's just been too long since there's been any a cure for a disease!

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  17. AD is a terrible, terrible disease. Everything a person has is their memories, once they are gone they're life is just not the same. I lost my mother to congestive heart failure but she had AD also. I think the decreased bloodflow made had sped up the progression of the disease. I can't prove it but you can't persuade me otherwise.

    As for cures for diseases: We are all ready for some cures. Greed is the epedemic now. The money is in the treatment, not the cure. Don't doctors (research doctors included) take an oath to cure? Maybe they don't. Well it would be the decent thing for the drug companies to throw out a cure once in a while. They're akin to drug dealers, keeping you coming back for drugs. Instead of a getting 'high' you get to live.

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  18. Excellent article. I am conducting a research project that may offer another perspective and I am seeking community input. My topic is: "Children and Their Influence on Mild-to-Moderate Alzheimer’s Patient Cognition." What role does socialization with younger people play in the progression of an Alzheimer's patient's disease?" Please share your thoughts by emailing markemiller@phoenix.edu. Thank you. Mark Elliott Miller, MPH, San Antonio, TX.

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  19. I totally agree, they don't really want cures, it is all about greed. My Mom had it, the facilities that treat them is lacking is so many ways. I took her out weekly, just to get her away from the funny farm, at the end she was wheel chair bound and I would get her outside and wheel her around the grounds. I was able to be with her in her last days, at a hospice that was just so wonderful and ministered to her needs. Thank God, it made things so much more bearable.
    Anonymous. .

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  20. Take a look at some of the many avoidable risk factors that may contribute to Alzheimer's disease
    http://www.polygenicpathways.co.uk/alzenvrisk.htm

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  21. First - Be VERY CAUTIOUS with seeking early detection. MCI (Mild Cognitive Impairment) is the latest buzz-word that is increasing the prescriptions for costly drugs that may not do anything, or may even create other problems. AND, once diagnosed, you've lost your ability to secure long term care insurance and possibly health insurance.

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  22. Everyone is addressing this issue from a myopic point of view. Around the globe, 155,000 people die every day, for a total of 57 million deaths annually. The birth rate is at 73 million people annually, meaning: the population growth of humans on planet Earth is outpacing death by a rate of 16 million people annually or roughly 2.5 billion every 14 years. It, therefore, is increasing at an exponential rate.

    Governments know that Earth's natural resources are all ready strained to the breaking point; and in fact; cannot feed the current population, much less supply them with potable water that is not available to begin with. In short, we are already stripping the planet of every resource it has to offer with some 7 billion people running around. What will happen, do you think, if that is allowed to run unchecked for another 14 years? Now you know why polio was the last disease ever cured in regards to the common man. As Print Ritter said on the movie Broken Trail, "We're all travelers in this world. From the sweet grass to the packing house. Birth 'til death. We travel between the eternities."

    Life and death are a natural occurrence for the human being, and should be embraced out of respect for the very planet that sustains us. I lost both my parents a few years back, so I know what it feels like. But I also know that I too, will do my part out of respect for what is Mother Nature's calling card.

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  23. My mom has ben sufering with AD for five years and is currently using the excilon patch with mixed results. I've noticed the patch helps more with physical coordination than mental cognition, although it does minimize the sever mental outbursts. Which of course is no small matter! I have tried B-vit's, but all they do esclate AD episodes and make it more difficult to handle her physicaly.Calc, Mag, Vit-D3 taken in small amounts have been useful in creating a seditive effect on mom. Taken in large amounts does nothing but give her a burst of energy and again hard to handle. By the way I've noticed when mom is going through her episodes the top of her head gets very hot to the touch. Anybody else experience that?

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  24. So what diet and preventative measures will help alleviate some of the progression or even the onset of this disease?

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  25. The posts are helpful, the articles are not. It was only recently that they had a way to see the degree of AD in the brain which was supposed to boost the ability to research it, but still have not heard much. The last breakthrough I read was that the plaques may be a process that can happen in other organs, it may be similar to what happens in the pancreas that results in adult diabetes.

    My Dad was too difficult to control for about 2 years when they took him to an emergency room. His primary Dr had prescribed a sedative which the neurologists at the hospital already knew was no help for an AD patient. It took them three tries in the hospital before they found a medication that calmed him down enough to be released. He was normally very calm, but when feeling threatened he would hit. It would help if doctors would consult a neurologist more often. Doctors have been too ignorant of the reality of caring for an AD patient.

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  26. On January 25, 2012, my 61 year old husband died from Alzheimer's Disease after a 12 year battle. Because he developed some behavioral problems typical of Alzheimer's patients, during the last two months of his life he was moved from his Alzheimer's specific assisted living residence (which he had only lived in for 6 weeks) to the local hospital for 6 days, then back to assisted living for 3 days, then to a psychiatric hospital for 2 weeks. But before assisted living would take him back he had to go to a nursing home for 14 days for "rehabilitation". When none of the 'decent' nursing homes (and I use the term loosely)would take him we said ENOUGH and brought him home. He died six days later. You are reading a very brief description that barely scratches the surface of the "living hell on earth" experience my darling husband had to go through. This is just one case. Are you ready for your loved one or yourself to be diagnosed with Alzheimer's Disease?

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